


Cas, remind me to never go hiking again.

by karaluvsketchup



Category: Supernatural
Genre: Gen, Human Castiel, Hurt Dean Winchester, Hurt/Comfort, basically just h/c without much plot so enjoy
Language: English
Status: Completed
Published: 2014-02-09
Updated: 2014-02-09
Packaged: 2018-01-11 17:29:07
Rating: Teen And Up Audiences
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 8,446
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/1175857
Author URL: https://archiveofourown.org/users/karaluvsketchup/pseuds/karaluvsketchup
Summary: <blockquote class="userstuff">
              <p>Cas is behind Sam, the closest to the beast, and it gets to him first, but just swats him aside and continues on it's charge. Sam, reacting to Dean's warning almost instinctively, pulls out his gun and lets off three shots in a row. The silver bullets hit it, and it stumbles, but it's only wounded and it almost instantaneously regains it's composure. Instead of going for Sam, however, the takes a leap up over the log, hitting Dean, then losing it's footing and sending both of them over the edge.</p>
            </blockquote>





	Cas, remind me to never go hiking again.

**Author's Note:**

> So, uh, this fic is pretty much brought to you by that one time I decided to go get Wilderness First Aid certified mostly just for shits and giggles. And also "Hey I like Dean, I want to make horrible things happen to him."
> 
> I wrote the majority of this during the first half of S9, hence Cas being human, but go ahead and assume this is somewhere in the future when Cas is human again, and the boys have at least somewhat worked out the major issues between them.
> 
> Enjoy!

“We're almost to where the last hiker was attacked,” Sam announces, looking at his map as he reaches a fork in the trail. Dean is lagging thirty feet behind him, not enjoying the hike nearly as much as his brother. It's mid-morning and they've already hiked five miles, steadily uphill, and Dean started whining an hour ago that he's getting too old for this. There's several reasons why they don't usually do these kinds of back-country hunts and at the top of the list is the simple fact that Dean doesn't like them. The combination of exertion, heat, and humidity has Dean's shirt sticking to his back, and the thought that there is at least another five miles of hiking between him and a slice of pie when they've caught the monster they're after feels like a personal insult.

Cas is keeping pace with Dean rather than pushing ahead with Sam, but he seems to be enjoying the hike, which Dean has chosen to see as something of a betrayal.

They had stopped for the night in Arkansas on the way back from killing a half-dozen demons in Tallahassee, and Sam had picked up a paper and announced that they had a case. Dean wasn't at all convinced that the three dead hikers over the last year were the work of a monster that some of the local yokels called the Ozark Howler, but Sam insisted that it would only take an extra couple of days for them to do a little asking around and hike out there and see if they could figure out what was going on. They didn't have any fresh leads on any demon or angel business anyway, and Dean was unable to convince him that it was a waste of time, so they had talked to a couple of forest rangers and then the most recent victim's girlfriend, who had been with him when he had been mauled to death. She hadn't gotten a good look at the beast, but described it as bear-sized, which would make it much larger than any normal wildlife that lived in the area. That had been enough for Sam to insist that they take the hike out, so here they were, smack dab in the middle of no where.

“You know, Sammy, even assuming this Howler thing is real, we're probably not finding it.”

“Less whining, more tracking, Dean,” Sam shoots back, starting to sound annoyed with his brother.

Dean rolls his eyes, but then realizes that Cas is no longer beside him and turns around to see the former angel by the side of the trail, looking at a tuft of what looks like black fur that is caught on a branch, a little more than three feet off the ground. When Cas sees Dean looking at him, he remarks “I believe I found something.”

Sam and Dean both jog back down the trail to get a better look. “Good find, Cas,” Sam beams. “Could be off of someone's dog, but it'd have to be a big one.”

“So, the most likely scenario is that it's from the beast we're looking for.” Cas confirms.

Sam nods. “So it's either crossed the trail right here, or it's been traveling along the trail.”

Dean is still unconvinced. “Man, I wish we had Bobby here. Or you know, any actual competent tracker.”

Sam insists that something as big as what the witness described is going to leave enough of a trail that it won't take an expert, and they each take a direction, looking for any footprints, broken branches, or any other sign that something large, hairy, and deadly had gone through.

Dean ends up being the first to find another clue – there's a downed log, about six feet in diameter, with what looks like claw marks twenty feet beyond where the tuft of hair was at the edge of the trail. “Hey, I've got something!” he yells out to Sam and Cas, and they make their way over to him as he climbs up the log to get a better look.

The log is a bit slippery and there's a steep drop off of at least 20 feet on the other side of the log so Dean stays on his hands and knees as he looks at the scratch marks on the top of the log. Whatever left them had very sharp claws and very large feet – definitely not a dog.

Dean looks up at Sam and Cas to tell them what he's found, and sees something huge, black, and hairy behind them.

“Behind you!” is all the warning he's able to get out before the beast attacks.

Cas is behind Sam, the closest to the beast, and it gets to him first, but just swats him aside and continues on it's charge. Sam, reacting to Dean's warning almost instinctively, pulls out his gun and lets off three shots in a row. The silver bullets hit it, and it stumbles, but it's only wounded and it almost instantaneously regains it's composure. Instead of going for Sam, however, the takes a leap up over the log, hitting Dean, then losing it's footing and sending both of them over the edge.

***

As soon as Sam sees the Howler go over the log with Dean, he's crossing the short distance to the log and scrambling up it himself. When he gets to the top, he sees Dean lying still at the bottom of the cliff, and the Howler next to him, unfortunately much less still. It gets up slowly and circles round to face Dean.

“Shit,” Sam mutters under his breath, before yelling, “Hey! Hey! UP HERE!”

The beast glances at him and snarles, but then turns back to Dean and grabs a leg in it's sharp teeth and starts dragging him.

Sam tries yelling some more, but that doesn't work and the Howler is almost to the edge of the clearing with Dean so he takes a deep breath, trying to steady his hands, and empties his gun into the beast. That seems to be enough of a distraction as the beast drops Dean's leg and stumbles off into the woods without him.

Sam turns around and sees Cas walking toward him. The former angel has some scratches across his cheek and he's holding one arm up against his body as if it's injured, but he looks like he's all right otherwise. “Sam!” He calls out. “Is Dean...” He trails off.

“He's down there, I think he's unconscious.” Sam tells Cas. “Come on, we've got to get to him.” Sam jumps down off the log on the uphill side, and the two of them go around the base of the fallen tree to where there is a steep slope instead of a cliff, and a minute later they're kneeling down on either side of Dean.

Sam calls out his brother's name several times, then rubs a couple of knuckles into his sternum, but Dean doesn't budge. Swearing under his breath, Sam leans over to put his ear to Dean's mouth while watching his chest, staying like that for a few seconds until he's sure that Dean's breathing – a little fast and a little shallow, but it'll have to do for now. Sam reaches for Dean's wrist next to check his pulse and is relieved to feel that it is strong and steady.

There's a noise not far off in the woods that tells Sam that the Howler is still alive, and maybe circling back. He looks up at Cas. “Are you hurt?”

Cas winces and nods. “Just my wrist, I fell on it wrong when it threw me, otherwise I'm fine. Is Dean alright?”

Sam wants to answer no, but Cas is already looking freaked out enough, so he just says, “Probably hit his head when he fell, and we won't know for sure what else is wrong until he wakes up or we get him to a hospital.”

“What can I do?” Cas asks.

Sam takes off his backpack, unzips it, and gets out the first aid kit. He holds it out to Cas, who takes it in his uninjured hand, looking back at him quizzically. “Still got your gun?” Sam asks, and after Cas nods, he tells the former angel, “Stay with him. I'm going after that thing.”

“What? Sam...” Cas protests, but Sam cuts him off.

“Dean's okay for now, but I need to go finish off that Howler before it comes back and attacks us again. I just need you to watch him, don't move him, and if he does wake up keep him calm. Can you do that, Cas?” Sam keeps his voice steady and commanding even though he's feeling anything but calm. Cas nods, and Sam stands up, reloading his gun with a new clip of silver bullets. “It's already injured, I've got this.”

It's hard leaving his brother's side, but Sam knows that at this point it's unlikely that Dean's going to be able to walk out of there, and since they're too far out to get cell service, that means one of them is going to have to hike out to get help. That means just one person will be there to take care of Dean while they wait for a rescue team, or better yet, a helicopter, to come, and if the Howler decides that it's recovered enough to attack again during that time, there might be no one left for the rescue team to rescue.

His gun at the ready, Sam moves as quietly and quickly as he can into the forest where he saw the Howler limp off. There's a trail of dark red blood, and it isn't moving nearly as gracefully as it had been before, so there's a path of broken plants that a tracker much less skilled than Sam could easily follow. Trying to keep his mind on his current mission instead of worrying too much about his brother, Sam makes his way through the underbrush, constantly listening for any sign of where the beast was going, if it was circling back toward Dean and Cas. He doesn't hear anything for several minutes, but the blood trail continues in a direction more or less in one direction and Sam starts to consider how long he should keep following before he can say with some confidence that the beast wasn't coming back.

Then he walks around a huge tree and suddenly finds himself face to face with the Ozark Howler.

***

Cas isn't sure how long he's been sitting and alternating between looking at Dean and looking at the edge of the forest, but it's long enough that Cas has had time to wrap a bandage around the bite on Dean's ankle and Dean is just starting to stir when there's a noise that sounds like something between the howl of a wolf and the bugle of an elk, and then, moments later the sound of Sam's gun going off multiple times. The gun sounds like it must be a good quarter mile away, but it's still loud enough to push Dean the rest of the way to consciousness. He lets out a groan and winces. “Whaaaaa...”

Cas leans over Dean's face, putting his uninjured hand on his cheek. “Dean, can you hear me? Can you open your eyes?” A moment later, Cas is relieved to see Dean's green eyes open a sliver.

“Cas?” Dean mumbles.

“Yeah, it's me, Dean. You fell pretty far so you need to stay still until we can figure out where you're hurt, okay?”

“'k,” Dean says, his eyes sliding closed again.

“Stay awake, Dean.” Dean opens his eyes again at Cas' command. “Can you tell me what hurts?”

“Uh... ribs, I think,” Dean groans. “Bunch'a ribs. Ankle. Head... E'rything.”

“Okay, just hang tight, Sam will be back any minute now and we'll get you fixed up.”

“Wh'r 'e go?”

“He went to finish off the Howler. Don't worry, he got it.” Cas isn't actually sure of that, but Dean looks like he could use some reassurance.

“S'mmy's good at th't,” Dean slurs.

“Yeah, he is.” Cas agrees.

They sit and talk for a few minutes, Cas just keeping Dean occupied so he doesn't fall asleep, before Sam comes running out of the woods. “How is he?” Sam pants.

“Awake.” Cas tells him, and Sam gets down on his knees beside his brother.

“Hey man, how you feeling?” He asks Dean when he sees that he is in fact conscious.

“Not great.” Dean tells him. “H'rts to breathe.”

“We'll get you taken care of, Dean.” Sam reassures him.

“Is the Howler dead?” Cas asks Sam.

Sam nods. “Five rounds of silver between the eyes did the trick. You guys won't have to worry about him anymore.”

Cas tilts his head. “How do you mean?”

“Look, Dean isn't in any condition to walk, much less hike five miles. So we're going to give him a once over and take care of what we can, and then I'm going to go get help.”

“Shouldn't you stay with him, Sam? I really don't know what to do...” Having only been a human for a relatively short time, Cas was still getting used to not being able to heal people with a touch of his hand, and therefore knew relatively little about conventional medicine.

“I'm the faster hiker, and you're injured too, Cas.”

“Wait, Cas... you're hurt too?” Dean says, sounding alarmed.

“It's just a sprained wrist,” Cas tells them both. “I can still walk.”

“Cas, I wouldn't ask you to do this if I didn't think it was the best way.”

“Okay, maybe.” Cas grumbles.

Satisfied, Sam turns his attention to giving Dean a thorough head-to-toe exam. As he works, he gives Dean and Cas an account of what happened in the woods, stopping once in a while to tell Dean what he was doing or ask if something hurt. Apparently the Howler had gone a ways, then stopped behind a tree to rest or regroup or something. Sam had found it and in it's weakened condition it had been unable to attack him before he emptied his gun into it's skull.

Sam finds a tender spot on the back of Dean's head, which goes along with what they're pretty sure is a concussion but could be a more serious brain injury. There's at least three broken ribs on the left side of his chest, and a few more that are bruised if not cracked. Dean's ankle has several small wounds from the Howler's teeth, with some bruising around them, but there doesn't seem to be anything broken. The bleeding has already nearly stopped, so Sam gives the ankle a thorough cleaning with some iodine from the first aid kit and re-bandages it.

Sam pulls a couple of pills out of the first aid kit and helps Dean take them with a sip of water, then they roll Dean over onto his side, which seems to help his breathing a little. “You're doing great, Dean,” Sam says, patting his brother on the hip. Dean makes a little noise that is probably a disagreement with that statement. Then Sam turns to Cas. “Can I talk to you for a minute?”

Cas nods, and they both get up and walk far enough away from Dean that he won't be able to hear what they're saying.

“If you're really not comfortable with being the one who stays with him, I can do it.”

“No, Sam, you're probably right. Just tell me what to do.”

“With any luck, you'll just need to stay with him, keep him calm, keep checking him over to make sure nothing's getting worse.”

“But?”

“His broken ribs are giving him a hard time with breathing, though hopefully the painkillers I gave him will help some. He could have a lung injury too, though, in which case his breathing is only going to get worse, so you'll have to watch for that.”

“And if he does get worse?”

“First of all, _you_ are going to have to stay calm, because not being able to breathe is scary as hell and he can't be worried about you freaking out too, okay?”

Cas nods.

“You can try and find a more comfortable position for him, I checked out his neck and he's not showing any signs of a spinal injury so if he thinks it'll help you can help him sit up. And the main thing is to keep encouraging him to take deep, steady breaths if he's struggling.”

“Okay, I can do that.”

“If it gets really bad you may need to give him rescue breaths to help him get enough air in. I don't think it's going to come to that, but you need to be prepared to do that. You know how to recognize if he's not getting enough oxygen?”

“Yeah.”

“Get him on his back, tilt his head back to open his airway, and give him a breath every five seconds. If he's still conscious explain what you're doing and get him to work with you. And if he passes out you're going to have to check every minute or so to make sure he still has a pulse.”

“Sam, how bad is this going to be?”

“I really don't know. I'm hoping that with the pain a little more under control, he'll be fine for the two or three hours that it'll take to get help out here. You just have to be ready in case he isn't.”

“Okay, and what about his other injuries?”

“He's conscious, and his pupils are normal and he's only a little disoriented, so I'm pretty sure his head's all right. Keep him awake if you can, and ask a few questions once in awhile to see if he's getting confused. And he's a little shocky so keep him warm. Other than that, I think he'll be all right.”

Cas gulps and nods.

“Now let me take a look at that wrist before I leave.”

They go back over and sit on the ground next to Dean while Sam prods at Cas's sore, swollen wrist and then puts a splint on it. “This is going to need an x-ray when you guys get to the hospital, but that should do you for now. Take a couple of aspirin if you need it.” Sam tells Cas.

Sam says a few reassuring words to Dean, then, leaving his pack and jacket behind and just bringing a water bottle and the keys to the Impala with him, Sam starts making his way up the hill, leaving Cas and Dean behind.

***

“Cas, remind me to...” Dean takes a breath in, since his last one was not quite big enough to finish the sentence. “...never go hiking again.”

“If you ever decide to go hiking after today, I will be sure to remind you that you said that.” Cas sounds like he tried to put some humor into the statement but didn't really succeed.

The concussion is screwing with Dean's sense of time a little, but he thinks he's been lying on this forest floor for at least an hour. His head's still throbbing, and his ribs hurt like a sonofabitch whenever he takes a breath in, which is frankly starting to get exhausting, which Dean knows is something to worry about since help may still be hours away. Cas keeps checking on him, obviously not sure of what's he's doing, but Dean thinks he's doing pretty well for a dude who is used to being able to heal things with a touch of his hand. They're going to have to get him some real first aid training one of these days, though.

Suddenly Dean feels a cough coming on, which is very not good. The first cough sends the pain in his ribs from bad to almost unbearable, and a few more has his vision starting to grey out from the pain. He feels Cas put a hand on his side, which helps to ground him and keep him from passing out, and after a few more hard coughs, Dean's able to stop. He screws his eyes shut and tries to concentrate on not letting the pain drag him down, but after a moment he realizes that Cas is talking.

“Dean. You need to breathe.”

Is he not breathing? Dean supposes not, since the pain in his ribs is constant, rather than coming in waves when he inhales and exhales.

“Take a breath in, you can do it, Dean.”

Dean breathes in, worsening his rib pain again, but it's gone back down to a steady but bearable roar. He breathes back out. And back in again.

“Try and make it as deep as you can. Get some air moving.”

Cas's voice is kind, but commanding, and Dean does his best to do what he's being told. Cas keeps saying encouraging words and Dean gradually gets back to breathing almost as well as he was right before he started coughing.

“Fuck.” He says when he finally has enough extra oxygen for the expletive.

“Do you want to rinse out your mouth?”

He hadn't really realized it before because he was occupied with other things, but yeah, Dean definitely tastes blood in his mouth from that coughing fit. He nods and Cas brings a water bottle to his lips. It's awkward drinking while lying on his side, and Dean's pretty sure that more water goes straight out the side of his mouth than into it, but he manages to get a mouthful of water, swill it around and spit it out. Cas wipes the water and blood off of Dean's face and then asks if he'd like some to drink and Dean nods again.

Drinking would be a lot easier if he could sit up without multiplying the pain in his ribs (everything would be a lot easier if he could do anything without multiplying the pain in his ribs) but they manage to get the majority of the water into Dean's mouth this time. Dean's pretty thirsty, but Cas doesn't think it's a good idea for him to drink too much at a time, and that seems like it might be reasonable so Dean doesn't bother to put forth the effort to argue.

***

Sam's been checking his phone every ten minutes all the way down the mountain, but apparently someone decided that this particular patch of wilderness didn't need cell service. Which is probably fine any other day, but today Sam's got a seriously injured brother out there and he knows that every minute it takes to get help to him could be the minute that Dean takes a turn for the worse.

Part of him wishes he'd let Cas be the runner and stayed with Dean himself, partly because his experience with field medicine is much more extensive, but more because he hates not knowing if his brother is all right (or, in this case, how far from all right he is) and all the years of the two Winchesters having no one to rely on but each other have left Sam with an instinctual-level desire to be the one to help his brother. But, he keeps reminding himself, Dean and Cas are also extremely close – Sam counts Cas among his closest friends, but Cas has always been more Dean's friend, or whatever he is, than Sam's. If nothing else, Sam can be sure that Dean isn't feeling alone.

Sam reaches the trailhead after an hour and a half of hiking as fast as the trail allowed, and he still doesn't have cell service, but he does have the Impala, and he remembers seeing a forest service fire station ten minutes down the road. At the very least, they'll have a landline he'll be able to use.

He gets in the car and pulls out and drives down the twisty mountain road toward the fire station as fast as he safely can. It's right where he remembered it was, and he allows himself to feel just a little relief as he pulls into the gravel driveway of the fire station.

***

Dean isn't doing very well.

The good news is that he's still conscious and he's still breathing marginally well enough on his own, but in the two hours since Sam left, Dean's had a half-dozen coughing fits that produce varying amounts of blood and each time it takes him longer and longer to get back to breathing almost as well as he had previously. Dean's face is paler than Cas has ever seen it, and over the last hour his pulse has gotten more rapid and Cas thinks it's also getting weaker. It's getting harder and harder for Cas to shoo away the question of what if help doesn't arrive on time.

At some point Cas offered Dean his hand and he's been gripping it like it's a lifeline ever since. He says that the pain hasn't gotten any worse, but Cas doesn't really believe him, knows that he's putting on a brave face. Dean does that.

Cas sits on the ground in front of Dean, holding onto his hand, watching for any sign of new distress. He's a little surprised when Dean starts speaking.

“When the 'copter comes...” He takes a painful breath in. “There should be a flare gun... in the pack.”

“Flare gun?”

“For a signal.” Dean clarifies. He closes his eyes, worn out by the effort of talking.

“Right.” Cas looks up and realizes that even though they're in a clearing, the actual gap in the forest canopy isn't very big and where they are, they're probably not visible from the air. He'd been busy enough worrying about Dean that he hadn't really thought about it, but at this point help is probably on the way and the easier it is for them to be found, the better. Cas squeezes Dean's hand then lets go of it and digs through Sam's pack until he finds the flare gun, and also a whistle, which he figures could also come in handy, so he sticks it in his pocket. Cas doesn't have any clue about the logistics of wilderness rescues, but a helicopter is obviously not going to be able to land right where they are.

He turns back to Dean and tells him he has the flare gun. Dean smiles at him for a fraction of a second before asking for another drink of water.

Ten minutes and one particularly worrisome coughing fit later, Cas hears a helicopter.

He isn't sure at first, thinking it might be a breeze and not wanting to get false hopes up, but as it draws closer he lets himself feel relieved. He waits a little longer until the helicopter sounds like it's very close, and then gets up, walks to the middle of the clearing, and shoots the flare gun into the air.

Not long after that, he hears the helicopter land somewhere not too distant – probably the large meadow that they passed a few hundred meters back on the trail. “Dean, I think I need to go up there and show them where you are.” Cas says once the sound of the helicopter's blades have slowed to a stop. Dean looks up at Cas and nods, and Cas squeezes Dean's shoulder in a manner that he hopes is reassuring, and starts climbing up to the trail.

When he reaches the trail, Cas sees three people in dark blue uniforms running toward him carrying various pieces of equipment. “Castiel Jones?” One of them asks when they reach where Cas is standing and he nods. “I'm Isaac, I'm a paramedic. This is my partner Julie and our pilot, Andy.”

Cas shakes their hands with his one good one and then tells them, “I'll show you to Dean.”

He leads them around the fallen tree and down the navigable slope that he and Sam have been using. Once they reach Dean there's a flurry of activity around him, with the medics taking out equipment, assessing Dean, asking him questions, asking Cas questions. Cas stands to the side, unsure of what he's supposed to do, but once they've completed an initial assessment and given Dean some much-needed oxygen, the second paramedic, Julie stands up and, putting a hand on Cas's upper arm to get his attention, asks what happened to his wrist.

“I uh, I tripped and fell on it. Right after Dean fell.”

“Did you feel or hear a pop? Or a crack?” She asks.

Cas shakes his head. “I don't think so. It just hurt.”

“Is it still hurting?”

“A little. Unless I try to move it, then it's fairly bad.”

She has Cas sit down, far enough from Dean that he's not in the way but close enough that he can see and hear everything that's happening, and takes his pulse and blood pressure, which Cas thinks is entirely unnecessary. Then she takes off the splint that Sam put on in order to look at Cas's swollen, bruised wrist, then takes a different splint out of her pack, which does a slightly better job at keeping the joint immobile.

Julie leaves Cas to go help the other two move Dean onto the backboard they brought. Dean has half his face covered by an oxygen mask and they've put a hard plastic collar around his neck. Andy, the helicopter pilot, is holding onto a bag of clear liquid, which is connected to a line that's going into Dean's right arm. The three medics roll Dean from his back onto his side, then move the backboard into position before rolling him back onto it.

As the medics work on strapping Dean onto the backboard, he reaches up and takes off his oxygen mask. “Where's Cas?”

Issac starts telling him that Cas is there, but Cas knows that may not be enough for Dean, so he scrambles over to where Dean can see him. “I'm right here, Dean,” he tells his friend, and that seems to calm Dean down.

A few minutes later the paramedics say they're good to go and they start the process of getting Dean up the hill and to the helicopter. Once Dean's loaded into the helicopter, Cas climbs up into a seat by his feet and the paramedics climb in after him as Andy gets the helicopter ready to take off. Julie hands Cas a headset and he puts it on just in time to hear Andy say that they'll be at the hospital in twenty minutes.

The helicopter lifts off, and while under other circumstances Cas would be enjoying the scenery as they fly over the wilderness, his focus now is entirely on Dean.

***

The closest parking spot that Sam can find outside the Emergency Room of Washington Regional Health Center is a good hundred yards from the door, but he's not about to get Dean's car towed, so he parks the car and runs the distance to the entrance. He walks the length of the half-full waiting room and explains to the triage nurse that his brother was brought in by helicopter, and she has an ER tech bring him back to the trauma room where they're working on Dean. Cas is sitting outside the trauma room, but he stands up when he sees Sam approaching.

“You all right, Cas?” Sam asks. Cas nods. He's looking a little shell-shocked but not too bad.

“If you'll just wait here for a second, I'll get someone to come speak to you,” The ER tech says to Sam before going into the trauma room. A few moments later he comes out with a petite woman in green scrubs at his heels.

She smiles at Sam. “Sam Bonham, right? Dean's brother?”

“Yeah,” he confirms. “And this is our friend Cas.”

“My name is Rita, I'm one of the nurses who has been working on Dean.”

“How is he?” Sam asks.

“Your brother sustained a serious injury to the left side of his chest - he has four fractured ribs, which caused a collection of air and blood to form around his lung, so they're putting in a chest tube. That will drain the air and blood and allow his lung to re-expand and make breathing easier.”

“So he'll be all right?”

“His doctor will be able to tell you more, but it's looking that way.”

Sam lets out a sigh of relief. “Can we go in and see him?”

“You might want to wait a few minutes until they're done placing the chest tube, it may be a little...”

“We can handle it.” Sam cuts her off. He's definitely seen worse.

“If you say so,” she says, smiling. “Follow me.”

They go into the trauma room where Dean is lying on a gurney, a blanket pulled up to his waist and his battered chest bare, with all the tubes and wires on him that Sam knows to expect. A woman in green scrubs is supporting his left arm while man wearing blue scrubs and a surgical mask works a tube into a hole in his side. Dean's pale, his eyes currently wrenched closed in pain, and he doesn't look good but Sam's seen him in worse shape quite a few times.

While Cas lingers near the foot of the bed, Sam walks up to Dean's side, opposite where the doctor is working, and stands near the head of the bed where he isn't in anyone's way. He puts a hand gently on his brother's shoulder. “Hey man, I'm here.”

Dean opens his eyes, looks up at Sam and smiles under his oxygen mask, muttering something that is probably “Sammy.”

***

“Here you go.”

Cas looks up and sees Sam holding a cup of coffee out to him. “Thanks,” he says, taking the cup. Dean had improved substantially after having close to a liter of blood drained out of his chest, but then they'd taken him away to get a CT scan, leaving Cas and Sam to wait in the emergency room.

“The nurse said she'll come get me to get my wrist x-rayed any minute.” Cas tells Sam as Sam sits down next to him. He hates having to worry about something so small as a broken wrist when they're still not completely sure that Dean isn't dying, but he knows that Sam and Dean both want him to get it looked after, so he's going along with it. Plus, the emergency room staff have assured him that they will do their best to not keep him away from his friend any more than necessary, and have been keeping with that so far.

“You doing okay, Cas?” Sam asks.

“Yeah, my wrist doesn't hurt that much.”

“That's not what I meant,” Sam's got that kind look in his eyes that he does so well.

“It's always hard... not being able to help.” Cas says, looking down at the floor.

“Look Cas, I know you're still getting used to being human again, but don't ever think it means that you're not helpful. You did good today.”

“I sat next to him and watched him cough up blood for two hours.”

“You were there for him. If you hadn't been there I would have still had to go run for help, and he could have died out there all alone.”

Cas frowns, pensively. He knows Sam is right. And Dean is, in all likelihood, going to recover without any supernatural intervention.

“Castiel Jones?” Cas looks up and sees a nurse he doesn't recognize calling his name.

“Yes?”

“If you'll come with me we can get that wrist x-rayed now.”

Cas gets up and follows her down the hall and through a door labeled Radiology. The x-rays themselves only take a few minutes, and then the nurse puts Cas's temporary splint back on and tells him that someone will come find him in when they've had a chance to look at the films. When he gets back to where Sam had been waiting the hunter isn't there, so he goes back to the trauma room and sees that Sam and Dean are both there again.

Dean lifts his oxygen mask off long enough to say, “Hey, Cas.”

“Dr. Sharp was about to give us an update.” Sam tells Cas, indicating the doctor who is standing on the other side of Dean's bed.

“You're the friend who came in with him?” Dr. Sharp asks, and Cas nods. They shake hands and then Dr. Sharp addresses Sam, Dean, and Cas. “The good news is that Dean's head CT didn't show any signs of bleeding or swelling, and the concussion should resolve on it's own in a few days. We did, however, find that he's had some bleeding from his spleen.”

“Does that mean he needs surgery?” Sam asks.

“Most likely not. It's a grade two laceration, which means that the tear is relatively small, and it looks like the bleeding has already stopped. We're just going to need to transfuse some blood and watch him closely over the next few days. Now, our main concern is still his thoracic injuries. The four broken ribs caused a fairly large hemopneumothorax, which means that his chest cavity filled with air and blood, compressing the lung. We inserted a chest tube, which drained the majority of that, but the CT scan did show a significant pocket of blood that hasn't successfully drained. That may just need a second chest tube to fix, or he may need to have thorascopic surgery in a few days to remove the clot. Are you with me so far?”

Sam and Dean nod, and the doctor continues. “We're also going to need to manage the rib pain.”

“I can tough it out.” Dean says under his oxygen mask.

“I'm afraid it's not a simple matter of toughing it out. With injuries like these, the pain prevents you from breathing as deeply as you need to, which can lead to complications – pneumonia, for a start.”

Dean lets out a little grumpy sigh, and then winces when that aggravates the pain in his ribs. He looks like he wants to speak again, but Sam does instead. “So what's the plan?”

“We'll be transferring him to the ICU soon, and once he's there, an anesthesiologist will be up to talk to you. With cases like this, the best option is usually regional anesthesia, either an epidural or a similar procedure called a thoracic paravertebral nerve block. Then we can reduce the IV pain meds, which will also help with his breathing.”

Dr. Sharp talks with the three of them (or mostly Sam and Cas, as Dean is half asleep) for a few more minutes, then excuses himself after listening to Dean's chest one more time.

Another fifteen minutes pass, the three hunters left alone and waiting, and then the nurse who took Cas to get x-rays walks in to tell him the doctor's ready to talk to him about his wrist. Cas doesn't really want to leave Dean's side, but Sam tells him to go, that he can follow them up if Dean gets transferred while he's busy.

“How's your friend doing?” The nurse, Nicole, asks Cas as they walk.

“His injuries are serious, but it looks like he will recover.” He answers.

“That's great.” She smiles at him, then opens the door to a room labeled _Exam 6,_ and tells him to take a seat on the bed, and the doctor will be in in a minute.

***

“'S he drawing... on my back?” Dean asks Sam. The doctor – not the one that was there in the emergency room, a different one, and anesthesiologist Dean thinks – seems to be feeling around his spine with a gloved hand and marking him up with a felt-tip pen.

“Yeah Dean, he's marking where your vertebrae are.” Sam says gently. It occurs to Dean that the anesthesiologist has been talking the whole time, maybe explaining what he's doing, but Dean's exhausted and the pain in his side is pretty distracting and he's also hopped up on morphine or something, so excuse him if he's not paying attention.

There's more fingers, more marker, maybe a ruler or something on Dean's back and Dean zones out for a few minutes, his eyes sliding shut. Then he hears the anesthesiologist say his name, probably, but doesn’t quite get around to responding until Sam squeezes his hand and says “Dean? Are you awake?”

Dean opens his eyes again. “Yeah.”

“Dean, I'm going to inject the local anesthetic to numb your skin now. This is going to sting a little, okay?” The anesthesiologist, who introduced himself as Dr. Hoffman or something, tells him.

“Yeah.” Dean says again because saying any more than that seems like more trouble than it's worth.

He feels a pin prick and then the familiar burn of the anesthetic going in, just to the left of the middle of his back. It's obviously not a good feeling, but Dean's already in enough pain, and also drugged enough, that he doesn't actually care that much. Sam keeps Dean's hand in his own throughout the process, which Dean kind of thinks he should be chastising his brother about but he's actually glad to have Sam there grounding him so he doesn't say anything.

Speaking of people who it's good to have around... “Where's Cas?” Dean asks his brother.

“He should be here soon. He's still down in the ER getting his wrist taken care of.”

“'S it bad?” Dean wonders aloud. As far as Dean could remember the former angel had been favoring his left hand in the woods but he didn't think that he'd been that badly injured.

“I don't think so,” Sam says reassuringly. “He just had to wait around longer than you did.”

“'Kay.”

There's the sound of a syringe being dropped into a sharps disposal box and the sting of the local anesthetic goes away. Dr. Hoffman says something about washing off Dean's back one more time, and he feels something cool, moist, and slightly rough go back and forth over a large section of his back. Sam's still there, which is good.

“Okay, Dean, now I'm going to insert the catheter for the nerve block – it goes in with a needle that gets pulled out afterward, just like an IV. This might be a little uncomfortable but you need to stay very still for me, okay?”

Dean nods, and Sam squeezes his hand reassuringly again, then shifts one of his own big hands up onto Dean's shoulder.

The local anesthetic must have done it's job, because Dean doesn't feel much of anything. He stays still as he was told because he is an adult and can follow directions or whatever, and vaguely feels something moving around back there. He looks up at Sam and sees that his little brother is intently watching the anesthesiologist, which is good, means someone's watching out for Dean and as much as he wouldn't admit it if you payed him, it's a good feeling.

Dr. Hoffman says that the catheter is in place, and he tapes it into place then injects something into it. “That side of your chest should start feeling numb in a few minutes.” He says as the nurse, with some help from Sam because Sammy insists on being helpful, repositions Dean onto his back. The doctor sticks around for a little while, making notes in Dean's chart and making sure that the block is doing it's job, and then he wishes Dean luck and turns to go. Sam thanks him, and so does Dean because the stabbing pain of the broken ribs is basically gone now, which pretty much puts the anesthesiologist on Dean's good list forever.

Dean dozes off for what feels like it was just a few minutes but really isn't sure, but then he's woken by Sam's voice (softly, probably with the intention of _not_ waking him up) saying, “Hey Cas.” He opens his eyes and sees Cas sinking into a chair next to Sam's, but then closes them again, content to know that his friend is there.

Cas inquires as to how Dean's doing, and Sam gives an accurate assessment that he's resting a lot more comfortably now, then asks Cas about his arm, which apparently didn't have any fractures the doctors could see on the x-ray but they want to check it again in a week just to be sure. They probably talk some more after that, but Dean falls asleep again.

***

_Beep. Beep. Beep. Beep._

Sam opens his eyes and rolls over in order to reach the alarm clock on the table between his bed and the one that Cas is sleeping in. The red numbers read 4:55 AM, and the early morning light is just starting to creep in around the curtains of the hotel room.

Cas is stirring by the time Sam has the alarm off. “We should leave in about 20 minutes,” Sam tell his friend, getting out of bed to head over to the coffee maker to get a pot started. As Dean's next-of-kin, Sam's allowed to be with him in the ICU throughout most of the day, but other visitors are only allowed for up to an hour at a time during particular times of day, the first of which starts at 5:30 in the morning. If they don't go now, Cas will have to wait until mid-morning.

By 5:15 they're both dressed and working on getting caffeinated, and Cas has a big dose of ibuprofen in his system to relieve some of the pain and swelling in his wrist – Sam knows that even if it isn't broken, the second day tends to be worse than the first. They head out the door and to the impala, and then drive the mile and a half back to the hospital.

The nursing staff must be on 12-hour shifts, because Dean's nurse is the same one who came on duty shortly after they got to the ICU the evening before, and she recognizes Sam and Cas as they walk in.

“Hey Gina,” Sam smiles at the nurse. “How's Dean doing?”

“He's stable,” Gina tells him. “Breathing's still not great, but that's to be expected. He's asleep right now, but you can go sit with him.”

“Thanks.” Sam walks over to Dean's bed, and Cas follows him. As the nurse said, Dean's sleeping, so they just take the two chairs next to him and sit, watching his chest rise and fall. Dean doesn't look too bad, considering that he spent three hours in the middle of no where with a collapsed lung yesterday. He still has an oxygen mask over his mouth and nose, and the bruises on his bare chest stand out dark against the paleness of his skin. Sam's seen Dean much worse than this, though. He's is all too familiar with the horrible stillness of Dean in a coma, not to mention that of Dean dead. But this is just Dean sleeping. He's going to be all right. Sam's not going to let himself believe otherwise.

A little after six, some kind of alarm goes off three beds over from Dean's , which is enough to make him open his eyes. He glances around for a moment before his eyes settle on Sam and Cas. Dean reaches up and takes his oxygen mask off. “Hey.”

“How'd you sleep, Dean?” Sam asks, hoping his voice sounds casual.

“Not terrible.” Dean replies.

They talk quietly for a few minutes before Dean goes back to sleeping, and shortly after that Gina, the nurse, comes by to tell them that visiting time is over. Sam hates to leave his brother's side, but it's not like he actually has a reason to go against hospital policy in this case, so he squeezes Dean's hand and says “See you later,” before walking out of the ICU.

***

Two weeks later, Cas has a bright blue cast reaching to just below his elbow after his follow-up x-rays showed that he did have a wrist fracture after all, and Dean, his two chest tubes removed and his pain manageable with the occasional Vicodin, is finally ready to leave the hospital.

“I can get dressed by myself,” Dean grumbles as Sam tries to help him with his t-shirt. Sam puts his arms up in resignation and allows Dean to struggle with the shirt, wincing as the movement hurts his broken ribs. He does manage to get it over his head on the second try, and once he's got it on all the way, Sam hands him a dark grey zip-up hoodie.

“I thought that would be more comfortable than one of your jackets, since we'll be in the car all day.” Dean's doctors had agreed that the best thing for him would be to continue his recovery in his own home instead of staying in a hotel, so they were making the long drive back to Lebanon as soon as he got the all-clear to leave the hospital.

Dean shrugs on the hoodie and zips it up, then looks over at his boots on one of the bedside chairs, debating whether leaning over to put them on is going to be worthwhile to avoid asking Sam for help. Sam doesn't give him enough time to make a decision on that, however, before he picks up one boot and starts loosening the laces. Dean stares at the opposite wall as his little brother slips the boot over his foot and ties the laces, just as Dean had done for him hundreds of times in the first four or five years of Sam's life.

Once Dean's dressed, the nurse comes in with a few last-minute forms to sign, and goes over his discharge instructions one more time. A few minutes later, he's sitting in a wheelchair at the main entrance to the hospital, and Cas is pulling up in the Impala.

“ _You let Cas drive my Baby?_ ” Dean hisses at Sam.

Sam laughs. “Just from where we parked to here, I promise.” He tells his brother before the former angel opens the door.

Dean knows he still has weeks of pushing against his brother trying to keep him from doing anything, and wincing whenever he moves too fast ahead of him, but as he settles into the back seat of the Impala and Sam drives off toward the Bunker, he knows the worst is behind him.

“What do you say, Sammy, another quick case on the way home?” Dean jokes as Sam pulls onto the interstate.

Sam doesn't say anything, but Dean can see him smiling in the rear view mirror.


End file.
